A client being treated for chronic cholecystitis should be given which of the following instructions?
A. Increase rest.
B. Avoid antacids.
C. Increase protein in diet.
D. Use anticholinergics as prescribed.
Correct Answer: D. Use anticholinergics as prescribed.
Conservative therapy for chronic cholecystitis includes weight reduction by increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain. Anticholinergics such as atropine and propantheline (Pro-Banth?-ne) relieve reflex spasms and smooth muscle contraction and assists with pain management.
Option A: Promote bedrest, allowing the patient to assume a position of comfort. Bedrest in low-Fowler’s position reduces intra-abdominal pressure; however, the patient will naturally assume the least painful position. Encourage use of relaxation techniques. Provide diversional activities.
Option B: Administer bile salts: Bilron, Zanchol, dehydrocholic acid (Decholin), as indicated. Promotes digestion and absorption of fats, fat-soluble vitamins, cholesterol. Useful in chronic cholecystitis.
Option C: Begin a low-fat liquid diet after the NG tube is removed. Limiting fat content reduces stimulation of the gallbladder and pain associated with incomplete fat digestion and is helpful in preventing recurrence. Advance diet as tolerated, usually low-fat, high-fiber. Restrict gas-producing foods (onions, cabbage, popcorn) and foods or fluids high in fats (butter, fried foods, nuts).
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